NCLEX-RN
NCLEX Psychosocial Integrity Questions
1. Which benefit accompanies mild apprehension?
- A. Physiological functions are slowed.
- B. There is an increased alertness.
- C. Behavioral responses become automatic.
- D. Ego defense mechanisms are mobilized.
Correct answer: B
Rationale: A mild level of anxiety can be beneficial because it increases alertness and focuses attention. Physiological functions are actually amplified initially, not slowed, due to mild apprehension; however, prolonged anxiety can lead to decreased function due to exhaustion. Automatic behavioral responses and ego defense mechanisms may hinder an individual's awareness rather than enhancing it, making them less beneficial compared to increased alertness.
2. Which psychosocial attribute plays an important role in the development of a healthy personality from birth to 1 year of age?
- A. Initiative versus guilt
- B. Trust versus mistrust
- C. Autonomy versus shame
- D. Industry versus inferiority
Correct answer: B
Rationale: According to Erikson's theory of psychosocial development, the first attribute that helps develop a healthy personality after birth is trust. Mistrust develops if the care provided to the infant is inconsistent. Initiative versus guilt is observed at 3 to 6 years of age, when children explore their surroundings and may experience guilt if their actions conflict with parental expectations. Autonomy versus shame occurs between 1 and 3 years of age, as children develop motor skills and new activities, with shame emerging if they feel self-conscious. Industry versus inferiority is evident in children aged 6 to 12 years, where successful task completion fosters a sense of industry, while excessive expectations can lead to feelings of inferiority. Therefore, the correct attribute for a healthy personality development from birth to 1 year of age is trust versus mistrust.
3. A female adolescent has anorexia nervosa and is malnourished and severely underweight. Which statement indicates that she is experiencing secondary gains from her behavior?
- A. "I'm huge; I'm as big as a house."
- B. "I get straight A's in all my subjects."
- C. "My mother keeps trying to get me to eat."
- D. "My hair is beginning to fall out in clumps."
Correct answer: C
Rationale: The statement "My mother keeps trying to get me to eat" indicates that the adolescent is experiencing secondary gains from her behavior. This is because the behavior has garnered attention from her mother, providing a sense of power and control, which are considered secondary gains. The statement "I'm huge; I'm as big as a house" reflects a disturbed body perception and is not related to secondary gains. Getting straight A's in all subjects is an achievement but not a secondary gain related to anorexia nervosa. The hair falling out in clumps is a physical consequence of starvation, not a secondary gain.
4. Which nursing action promotes psychosocial development for a newborn?
- A. Washing hands before holding the newborn
- B. Measuring the newborn using an approved length board
- C. Weighing the newborn on the same scale during hospitalization
- D. Placing the newborn in the mother's arms during the first hour of life
Correct answer: D
Rationale: Placing the newborn in the mother's arms during the first hour of life is a crucial nursing action that promotes psychosocial development by fostering bonding between the newborn and the mother. This skin-to-skin contact enhances emotional attachment, facilitates breastfeeding initiation, and provides a sense of security for the newborn. It helps in regulating the newborn's temperature, heart rate, and breathing, promoting overall well-being. Washing hands before holding the newborn is essential for infection prevention and control to maintain the newborn's health and safety. Measuring the newborn using an approved length board and weighing the newborn on the same scale during hospitalization are assessments aimed at monitoring the newborn's physical growth and development, rather than directly promoting psychosocial well-being.
5. When a client who has had a mastectomy sees her incision for the first time, she exclaims, 'I look horrible! Will it ever look better?' Which response would the nurse provide?
- A. 'You seem shocked by the way you look now.'
- B. 'Now that the tumor is gone, the area will heal quickly.'
- C. After it heals, others won't even know you had surgery.'
- D. 'You will feel better about it when the swelling subsides.'
Correct answer: A
Rationale: The correct response, 'You seem shocked by the way you look now,' acknowledges the client's feelings and provides an opportunity for the client to express emotions freely. This reflection of feelings may help promote eventual acceptance of body image changes. Choices B, C, and D provide false reassurance and negate the client's feelings. Saying that the area will heal quickly now that the tumor is gone dismisses the client's concerns. Similarly, stating that others won't know about the surgery or that the client will feel better once the swelling subsides does not address the client's current emotional state and may undermine trust in the nurse-client relationship.
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